Provider Demographics
NPI:1386307650
Name:NORWELL PEDIATRICS, LLC
Entity type:Organization
Organization Name:NORWELL PEDIATRICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-285-8819
Mailing Address - Street 1:164 WASHINGTON ST STE 102
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1727
Mailing Address - Country:US
Mailing Address - Phone:781-285-8819
Mailing Address - Fax:781-468-9158
Practice Address - Street 1:164 WASHINGTON ST STE 102
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1727
Practice Address - Country:US
Practice Address - Phone:781-285-8819
Practice Address - Fax:781-468-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty